Young Yui-Rwei, Lee Chien-Chang, Sheu Bor-Fuh, Chang Shy-Shin
Department of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Neurocrit Care. 2007;7(3):238-40. doi: 10.1007/s12028-007-0059-z.
Neurogenic cardiopulmonary complications associated with acute brain injury other then subarachnoid hemorrhage were seldom reported, especially in the pediatric population. We report a child who developed cardiac arrhythmia, severe myocardial injury and neurogenic pulmonary edema after cerebellar hemorrhage.
An 11-year-old girl had abrupt onset of spontaneous cerebellar hemorrhage presented with a fulminant picture of hypertension, supraventricular tachyarrhythmia, markedly elevated cardiac enzyme (troponin-I > 50 ng/ml), and acute pulmonary edema. The cardiopulmonary complications were deemed neurogenic because of their rapid onset after brain injury and exclusion of external blunt chest injury, resuscitative injury, and risks for underlying cardiac disease.
In addition to SAH, severe neurogenic cardiopulmonary complications could develop in pediatric patients with cerebellar hemorrhage. Supraventricular tachycardia may be an uncommon presenting rhythm that warrants considering cerebral etiology in patients without apparent cardiac risk.
除蛛网膜下腔出血外，与急性脑损伤相关的神经源性心肺并发症鲜有报道，尤其是在儿童群体中。我们报告了一名在小脑出血后出现心律失常、严重心肌损伤和神经源性肺水肿的儿童。
一名11岁女孩突发自发性小脑出血，表现为高血压、室上性快速心律失常、心肌酶显著升高（肌钙蛋白I>50 ng/ml）和急性肺水肿的暴发性症状。由于心肺并发症在脑损伤后迅速出现，且排除了外部钝性胸部损伤、复苏损伤和潜在心脏病风险，因此被认为是神经源性的。
除蛛网膜下腔出血外，小儿小脑出血患者可能会出现严重的神经源性心肺并发症。室上性心动过速可能是一种不常见的表现节律，对于无明显心脏风险的患者，应考虑脑部病因。
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